Evidence map›Paper›PMID 40626886›Full record

Observational studyActa anaesthesiologica Scandinavica2025

Innate Immune Response After Cardiac Arrest (INNATUS): A Study Protocol for an Observational Single-Center Pilot Study.

Asser M J Seppä, Huai Hui Wong, Luz E Cabrera, Dawit A Yohannes, Maria Heliste, Marjaana Tiainen, Johanna Hästbacka, Markus B Skrifvars, Eliisa Kekäläinen, Pirkka T Pekkarinen

Abstract readObservational Study
In one paragraph

Observational study in Acta anaesthesiologica Scandinavica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Asser M J SeppäDivision of Intensive Care Medicine, Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID 0000-0003-1507-3301
Huai Hui WongDepartment of Bacteriology and Immunology, University of Helsinki, Helsinki, Finland.
Luz E CabreraDepartment of Bacteriology and Immunology, University of Helsinki, Helsinki, Finland.
Dawit A YohannesDepartment of Bacteriology and Immunology, University of Helsinki, Helsinki, Finland.
Maria HelistePerioperative and Intensive Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Marjaana TiainenDepartment of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Johanna HästbackaDepartment of Intensive Care, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland.
Markus B SkrifvarsDivision of Intensive Care Medicine, Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID 0000-0002-0341-0262
Eliisa KekäläinenDepartment of Bacteriology and Immunology, University of Helsinki, Helsinki, Finland.ORCID 0000-0001-6045-108X
Pirkka T PekkarinenDivision of Intensive Care Medicine, Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID 0000-0002-8203-3409

Funding

Einar och Karin Stroems stiftelseFinska LäkaresällskapetKirsti och Tor Johanssons Hjärt- och CancerstiftelseMedicinska Understödsföreningen Liv och Hälsa
6 · The paper itself

Abstract

backgroundThe treatment of cardiac arrest (CA) patients is often complicated by post-cardiac arrest syndrome (PCAS), which involves a systemic inflammatory response. Increased levels of certain inflammatory markers (e.g., interleukin-6 and procalcitonin) are associated with higher mortality and worse neurological outcomes. Previous studies have focused on the prognostic value of individual markers, whereas the interplay between inflammatory mediators in the setting of CA remains largely unclear. In this study, we aim to examine the patterns of inflammatory markers and their association with the severity of organ failure and 6-month neurological outcomes in adult CA patients.

methodsThis is a prospective observational single-center study. The study cohort consists of 40 adult CA patients admitted to the ICU after successful resuscitation, and a control group of 40 patients undergoing elective coronary artery bypass graft (CABG) surgery. Patient enrollment started in January 2022 and was completed in April 2025. The last follow-up samples and interviews are due in October 2025. We collect blood samples upon ICU admission, at 4, 8, 12, and 24 h after return of spontaneous circulation (ROSC) and on the mornings of treatment Days 1-4. We combine clinical data with proteomic, transcriptomic, and flow cytometric analyses of blood samples to generate a comprehensive systems immunology landscape of the PCAS. The control group of CABG patients is used to assess inflammatory changes related to surgical trauma and ICU treatment in general, with the goal of distinguishing inflammatory disturbances specific to CA. This allows the identification of complex inflammatory pathways relevant to the pathogenesis of PCAS. The gathered information can then be used to plan future anti-inflammatory interventional trials. The primary outcomes of the study are the severity of organ failure during the first 96 h after ROSC and neurological outcome at 6 months. We will assess these using a modified SOFA score and the Modified Rankin Scale, respectively. We will use principal component analysis, latent profile analysis, and hierarchical clustering to identify patient subgroups with similar immunological response profiles. We will assess the correlation of different immunological response profiles with primary outcomes using linear mixed-effects models.

Indexed as

Heart ArrestImmunity, InnatePost-Cardiac Arrest SyndromeBiomarkersFemaleHumansMaleMiddle AgedPilot ProjectsProspective StudiesBiomarkerscardiac arrestinflammationinnate immunityresuscitationsystems immunology

Identifiers

PMID40626886
PMCPMC12236270

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.